Watkins Rochelle E, Mak Donna B, Connelly Crystal
Australian Biosecurity CRC, Curtin University, Perth, Western Australia, Australia.
Rural Remote Health. 2011;11(2):1621. Epub 2011 Mar 16.
Prisoners frequently engage in high risk behaviours for sexually transmitted infections (STIs) and blood borne viruses (BBVs) and effective interventions are required to control the transmission of STIs and BBVs among prisoners. The variation in engagement in high risk behaviours among prisoner sociodemographic sub-groups in Western Australia, including differences between prisoners admitted to metropolitan and regional prisons, has not been systematically described. The objective of this article was to describe self-reported engagement in unprotected sex and sharing injecting equipment among prisoners on admission to prison in Western Australia, using routinely collected data.
A retrospective medical record audit was conducted for a total of 946 individuals admitted to prisons in Western Australia. Quota sampling was used to ensure adequate sampling of females, juveniles, and individuals from regional prisons. Initial health assessment records completed on admission to prison in Western Australia were audited to evaluate self-reported engagement in unprotected sex and the sharing of injecting equipment among prison entrants.
Unprotected sex in the previous 12 months was reported by 48% of prisoners, and ever sharing injecting equipment was reported by 16% of prisoners. Adults were more likely to report both unprotected sex (52%) and sharing injecting equipment (18%) than juveniles (40% and 11%, respectively). Adults admitted to a metropolitan prison were significantly more likely to report sharing injecting equipment (23%) than adults admitted to a regional prison (10%). Associations between risk behaviours, sex and Aboriginality differed among prisoners admitted to metropolitan and regional prisons.
There is distinct sociodemographic patterning of high risk behaviours among prisoners in Western Australia by age, sex, Aboriginality and prison location. The effectiveness of interventions to prevent STI and BBV transmission in prisoners may be enhanced by addressing the diversity in the prison population, including the differences identified in reported risk behaviours between prisoners admitted to metropolitan and regional prisons. Culturally appropriate and comprehensive interventions are required to promote risk-reducing behaviours and address the health needs of all prisoners in Western Australia.
囚犯经常从事感染性传播感染（STIs）和血源病毒（BBVs）的高风险行为，因此需要有效的干预措施来控制STIs和BBVs在囚犯中的传播。西澳大利亚州囚犯社会人口亚群体在高风险行为参与方面的差异，包括被关押在大城市监狱和地区监狱的囚犯之间的差异，尚未得到系统描述。本文的目的是利用常规收集的数据，描述西澳大利亚州囚犯入狱时自我报告的无保护性行为和共用注射器具的情况。
对西澳大利亚州监狱收治的946名囚犯进行了回顾性病历审核。采用配额抽样以确保女性、青少年以及来自地区监狱的人员有足够的样本量。审核西澳大利亚州囚犯入狱时完成的初始健康评估记录，以评估自我报告的无保护性行为和监狱新入人员共用注射器具的情况。
48%的囚犯报告在过去12个月中有过无保护性行为，16%的囚犯报告曾共用注射器具。成年人比青少年更有可能报告无保护性行为（分别为52%和40%）和共用注射器具（分别为18%和11%）。被关押在大城市监狱的成年人比被关押在地区监狱的成年人更有可能报告共用注射器具（分别为23%和10%）。大城市监狱和地区监狱的囚犯在风险行为、性别和原住民身份之间的关联有所不同。
西澳大利亚州囚犯的高风险行为在年龄、性别、原住民身份和监狱地点方面存在明显的社会人口模式。通过应对监狱人口的多样性，包括大城市监狱和地区监狱囚犯在报告的风险行为方面的差异，可能会提高预防囚犯中STI和BBV传播的干预措施的有效性。需要采取符合文化背景且全面的干预措施，以促进降低风险行为，并满足西澳大利亚州所有囚犯的健康需求。
